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Published on: July 5, 2021
Application of endoscopy to the surgical management of craniopharyngiomas
1Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital, Suite 3, Level 7 Barker Street, Randwick, NSW 2031, Australia. enquiries@neuroendoscopy.info
Objective:
The purpose of this study was to evaluate the efficacy of a minimally invasive/endoscopic approach to craniopharyngiomas (CPGs) given that the surgical aim was a complete excision of the tumor as a single stage procedure. The endoscope can be used with both a subfrontal and a transsphenoidal approach.
Methods:
This study is a retrospective review of 36 operative patients who were seen by one surgeon. All patients had attempted complete excision.
Results:
Patients were divided into three groups according to their preoperative status. Those in group 1 had no previous treatment and fared well, although all developed postoperative diabetes insipidus. Those in group 2 had previous surgery only and also did well with repeat surgery. Those in group 3 had been treated previously with surgery and radiotherapy and, apart from a single exception, did poorly.
Conclusion:
The endoscopic, minimally invasive approach is versatile and effective in the surgical management of both first-time and repeat cases of CPG. It offers superior visualization of surrounding neurovascular structures and allows a more complete resection of tumor. It can be used for a cranial or a nasal approach to these tumors. Sadly, it failed to prevent postoperative endocrinopathy.
